POS1478 THE QRISK3 CLASSIFIED MORE JAPANESE SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) PATIENTS AS HIGH RISK OF ATHEROSCLEROTIC CARDIOVASCULAR DISEASE (ASCVD) WHEN COMPARED TO THE HISAYAMA STUDY SCORE
Authors: T. Kozuki, H. Tsuji, Y. Takase, Y. Nakakubo, T. Iwasaki, T. Yoshida, M. Shirakashi, H. Onizawa, R. Hiwa, K. Kitagori, S. Akizuki, R. Nakashima, A. Onishi, M. Tanaka, H. Yoshifuji, A. Morinobu
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The QRISK3, an atherosclerotic cardiovascular disease (ASCVD) risk tool including SLE as a risk factor, has been reported to demonstrate better performance in predicting risk of ASCVD in SLE patients compared with Framingham risk score (FRS) [1]. However, it is unknown how the QRISK3, the risk score established in the United Kingdom (UK), can estimate the ASCVD risk of Japanese SLE patients in comparison to the risk score validated for the Japanese population. <h3>Objectives</h3> To compare two algorithms for ASCVD risk estimation, QRISK3 and Hisayama study score [2], a general risk calculator used in Japan Atherosclerosis Society (JAS) guideline for Prevention of Atherosclerotic Cardiovascular Diseases 2022, in our cohort of Japanese SLE patients. <h3>Methods</h3> We performed a cross-sectional study in SLE patients attending Kyoto University Hospital by using questionnaires and laboratory tests. In primary prevention subjects without high-risk comorbidities (peripheral artery disease, chronic kidney disease, diabetes) and aged 40 to 79, both the Hisayama study score based on traditional risks (sex, systolic blood pressure, glucose intolerance, serum lipid and smoking) and QRISK3 (ethnicity was selected as "Other Asians") were calculated to estimate the ASCVD risk over the next 10 years. <h3>Results</h3> Among 335 patients enrolled, 105 were eligible for both ASCVD risk calculators. QRISK3 estimated 46 patients as high risk (score &gt;10 %), while the Hisayama study score classified no patients as high risk. The patients classified as high risk by QRISK3 had significantly higher Hisayama study score (4.71 [3.99-5.43] vs 2.28 [1.77-2.80], p&lt;0.0001) and more traditional risks, such as old age (59.8 [57.6-62.1] vs 48.1 [46.8-49.4], p&lt;0.0001), current smoking (9 [19.5%] vs 3 [5%], p=0.02) and hypertension on treatment (22 [47.8%] vs 7 [11.8%], p&lt;0.0001) than the patients with low-moderate risk (Table1). QRISK3 score was positively correlated with the Hisayama study score (r=0.4945, p&lt;0.0001). As a reference for each risk stratification score, the proportions to achieve target values for serum low-density lipoprotein cholesterol (LDL-C) recommended by the JAS guideline were 94.3 % and 69.5 % respectively. <h3>Conclusion</h3> QRISK3 classified more Japanese SLE patients as high risk of ASCVD when compared to the Hisayama study score. Lipid management might be insufficient according to QRISK3. The validation of QRISK3 by longitudinal studies should be warranted in Japanese SLE patients. <h3>References</h3> [1]Lisa Zhu et al. Assessing the validity of QRISK3 in predicting cardiovascular events in systemic lupus erythematosus. Lupus Sci Med. 2022 Feb;9(1):e000564. [2]Takanori Honda et al. Development and Validation of a Risk Prediction Model for Atherosclerotic Cardiovascular Disease in Japanese Adults: The Hisayama Study. J Atheroscler Thromb. 2022 Mar 1;29(3):345-361. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Tomohiro Kozuki: None declared, Hideaki Tsuji: None declared, Yudai Takase: None declared, Yuto Nakakubo: None declared, Takeshi Iwasaki: None declared, Tsuneyasu Yoshida: None declared, Mirei Shirakashi: None declared, Hideo Onizawa: None declared, Ryosuke Hiwa: None declared, Koji Kitagori: None declared, Syuji Akizuki: None declared, Ran Nakashima: None declared, Akira Onishi: None declared, Masao Tanaka: None declared, Hajime Yoshifuji Grant/research support from: GlaxoSmithKline (GSK), Akio Morinobu: None declared.